Association between adherence to statin therapy and low-density lipoprotein cholesterol (LDL-c) response in first-time users of standard-dose and low-dose statins: the PharmLines initiative

Sylvi Irawati*, Johanna E. Emmens, Stijn de Vos, Jens H.J. Bos, Rudolf A. de Boer, Eelko Hak

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)

Abstract

Objective: To investigate whether statin adherence (defined as proportion days covered, PDC) is associated with LDL-c response in statin initiators on standard and low starting doses of statins, and to detect a possible interaction with sex. Methods: An inception cohort study was conducted using the PharmLines Initiative, a linkage between the Lifelines Cohort Study and the University of Groningen’s IADB.nl (prescription database). First-time statin users were followed from baseline to follow-up measurement. We matched participants (1:1) between the standard-dose and the low-dose group of statin users on the duration of follow-up. Multiple linear regression analysis was used to model the association. Results: In univariate analysis, PDC was significantly associated with LDL-c response similarly (slope = −0.021), in both the standard-dose group (N = 115, p <.001) and the low-dose group (N = 115, p =.003). In the standard-dose group, the same level of PDC appeared to be significantly associated with a greater LDL-c level reduction in women (slope = −0.027, N = 48, p <.001) than in men (slope = −0.017, N = 67, p <.001). Meanwhile, in the low-dose group, the reduction of LDL-c level from baseline seemed to be greater in men (slope = −0.023, N = 56, p <.001) than in women (slope = −0.020, N = 59, p <.001) for the same level of PDC. In multiple regression analysis, the significant association between PDC and LDL-c with a similar pattern to the univariate result was maintained only in the standard-dose group. Conclusions: Adherence is significantly associated with LDL-c response to statins at follow-up. Sex appears to significantly modify this association. At a similar adherence level, women seem to experience a better LDL-c response to standard-dose statins compared to men in a real-world setting.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalCurrent Medical Research and Opinion
Volume38
Issue number1
DOIs
Publication statusPublished - 2022
Externally publishedYes

Bibliographical note

Funding Information:
The Lifelines Biobank initiative has been made possible by funds from FES (Fonds Economische Structuurversterking), SNN (Samenwerkingsverband Noord Nederland) and REP (Ruimtelijk Economisch Programma) and The IADB.nl is funded by the University of Groningen. The Indonesia Endowment Fund for Education (Lembaga Pengelola Dana Pendidikan, LPDP) of the Ministry of Finance of the Republic of Indonesia funded SI’s PhD program and had no role in all aspects of the study conduct or publication.

Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.

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